| NPI | 1811375017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PETERKIN Case Manager Supervisor 757-779-4493 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102368) |
| Enumeration Date | 2015-05-08 |
| Last Update Date | 2015-05-08 |